Consensus guidelines for diagnosis and management of anemia in epidermolysis bullosa.
Study Goal
The researchers aimed to establish consensus guidelines for the diagnosis and management of anemia in patients with epidermolysis bullosa (EB), including the use of iron supplementation.
Results Summary
The study generated 26 consensus statements, resulting in 6 recommendations for managing anemia in EB patients. Iron supplementation (oral or infusion) was recommended based on anemia severity, with dietary measures advised for all patients.
Population
Patients with moderate to severe forms of epidermolysis bullosa (EB).
Effective Dosage
Not specified (oral iron for mild anemia; iron infusion for moderate to severe anemia).
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Dietary measures | decrease | anemia | all EB patients | - | should be offered as part of management | #1 |
oral iron supplementation | decrease | mild anemia | EB patients | - | should be used | #2 |
iron infusion | decrease | moderate to severe anemia | EB patients | - | is reserved for | #3 |
transfusion | increase | Hb | adults | < 80 g/L (8 g/dL) | should be administered | #4 |
transfusion | increase | Hb | children | < 60 g/L (6 g/dL) | should be administered | #5 |
BACKGROUND: Anemia is a common complication of severe forms of epidermolysis bullosa (EB). To date, there are no guidelines outlining best clinical practices to manage anemia in the EB population. The objective of this manuscript is to present the first consensus guidelines for the diagnosis and management of anemia in EB. RESULTS: Due to the lack of high-quality evidence, a consensus methodology was followed. An initial survey exploring patient preferences, concerns and symptoms related to anemia was sent to EB patients and their family members. A second survey was distributed to EB experts and focused on screening, diagnosis, monitoring and management of anemia in the different types of EB. Information from these surveys was collated and used by the panel to generate 26 consensus statements. Consensus statements were sent to healthcare providers that care for EB patients through EB-Clinet. Statements that received more than 70% approval (completely agree/agree) were adopted. CONCLUSIONS: The end result was a series of 6 recommendations which include 20 statements that will help guide management of anemia in EB patients. In patients with moderate to severe forms of EB, the minimum desirable level of Hb is 100 g/L. Treatment should be individualized. Dietary measures should be offered as part of management of anemia in all EB patients, oral iron supplementation should be used for mild anemia; while iron infusion is reserved for moderate to severe anemia, if Hb levels of > 80-100 g/L (8-10 g/dL) and symptomatic; and transfusion should be administered if Hb is < 80 g/L (8 g/dL) in adults and < 60 g/L (6 g/dL) in children.